Blood donor deferral patterns in Iran: six-year national analysis (2016-2021)

Blood donor deferral has a significant impact on the adequacy of blood supply and donor retention globally. Understanding deferral patterns is crucial for optimizing donation services and ensuring a sustainable blood supply in middle-income countries with established voluntary donation systems. The aim of this study was to analyze the prevalence, temporal trends, and causes of blood donor deferrals across Iran using a comprehensive 6-year national dataset (2016-2021).

We conducted a retrospective analysis of all voluntary blood donation attempts recorded in Iran's "Negareh" database (2016-2021). Data included demographics, donation history, deferral status, and provincial variations. Non-parametric tests and chi-square analyses were performed (p<0.05).

Among 12,966,574 donation attempts, 2,161,808 individuals (16.67%) were deferred: 14.37% temporarily and 2.30% permanently. Deferral rates varied significantly by experience: 32.19% for first-time donors, 18.18% for repeat donors, and 8.98% for regular donors (η²=0.24, p<0.001). Female donors had higher deferral rates than males (30.68 vs 14.08%; odds ratio=2.70, p<0.001). Provincial rates ranged from 11.60% to 26.90%, inversely correlating with the Human Development Index (r= -0.67, p<0.001). Primary deferral reasons were high-risk behaviors (27.80%), general health unfitness (21.60%), and donor record issues (16.89%).

Iran's 16.67% deferral rate falls within global ranges but shows potential for optimization. The predominance of temporary deferrals (86.2%) and their association with modifiable factors suggest that targeted interventions could reduce deferrals by 2-3% while maintaining safety. Gender-specific prevention of anemia, enhanced preparation of first-time donor, and province-specific approaches could improve the donor experience and blood supply sustainability.